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Newsletter Article


Health and Social Care Bill Published

In January, Health Secretary Andrew Lansley published the Health and Social Care Bill 2011, which introduced in Parliament the health care reforms first proposed in the white paper "Equity and Excellence: Liberating the NHS." The plans aim to create a more patient-centered, physician-led National Health Service (NHS) that is focused on improving health care outcomes.

The reforms would abolish England’s 152 primary care trusts, which currently plan services and determine how money is spent, by 2013. At that point, groups of GPs known as GP consortia, overseen by a new NHS Commissioning Board, would take control of 80 percent of the NHS budget (over £80 billion) and be responsible for buying, or "commissioning," services for their patients.

Also in January, a second wave of 89 groups of GP pathfinders, or pilot GP consortia, was selected to test commissioning arrangements. Combined with the first wave announced in December, a total of 141 pathfinders covering 28.6 million people across England (roughly half the population) will now directly commission services for their patients.

To increase accountability in the NHS, the Health and Social Care Bill would also require each local authority (e.g., local governments, local health authorities) to create a health and well-being board to oversee quality of local services. In addition, Healthwatch England, a new consumer advocacy body, would be created within the Care Quality Commission (the existing NHS quality regulator) to mediate consumer complaints, as well as support patients in their decisions about where to receive care.

The bill would also require all hospitals in England to become semi-independent foundation trusts by 2014. Foundation trusts are NHS hospitals that perform well on a range of predominantly fiscal indicators and are afforded some clinical, managerial, and fiscal autonomy. Turning all hospitals into foundation trusts means that they would compete with each other for patients, including on price. Roughly half of the hospitals across England are currently foundation trusts.

Public Health England, a new agency charged with improving public health and reducing health inequalities, would also be established. Secretary Lansley said that, in total, the proposed measures would cost an estimated £1.4 billion to implement, but would save the NHS more than £5 billion by the year 2014–15, and an additional £1.7 billion each year thereafter. Most of the savings would be achieved by abolishing of the strategic health authorities and primary care trusts, as well as by cutting roughly 24,500 management staff.


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